Introduction

Before a child even enters the world, doctors strive to determine one of the most basic and core identities of the child, i.e. its sex. The Sharia legislates laws that vary based on the sex of the individual, such as rulings pertaining to prayer, hijab, travel, inheritance, marriage, and most other chapters of jurisprudence. This paper addresses whether the Sharia recognizes changes in the sex of an individual if one has undergone Sex Reassignment Surgery and/or hormone therapy to adopt characteristics of the opposite sex, as this impacts several aspects of Sharia laws. For example, if a woman decides to change to a man through the above procedures, does the Sharia not require hijab or a maḥram for her, grant her a different share of inheritance, and permit her to wear the two sheets of iḥrām in Hajj? Likewise, if a man hopes to become a woman and undergoes such procedures, does the Sharia require him to stand in the woman’s rows of prayer, remove the obligation of the congregational Friday prayer, and allow him to marry a man? This subject also guides one’s interactions with non-Muslims who have undergone such procedures, such as whether a Muslim woman can shake hands with a man who underwent sex change procedures to adopt a female identity.

For clarity, one must understand that gender, often used synonymously with sex, also entails social and cultural aspects, such that a person may choose to identify as a gender different than his sex, which is the case with transgenders who identify with a gender that differs from their biological sex at birth. Hence, this paper uses the term sex, as opposed to gender, to refer to one’s biological classification as a male or a female. Additionally, a transman refers to an individual who was born a woman but now self-identifies as man, while a transwoman refers to an individual who was born a man but now self-identifies as a woman.

Defining Sex

Medicine defines a sex based off the presence of the Y chromosome in an individual; men have a Y chromosome, whereas women do not. The Sharia accepts this definition, as long as the external genitalia do not indicate to the contrary at birth, such as in the rare cases of Androgen Insensitivity Syndrome, where external female genitalia develops despite a Y chromosome, in which case medical doctors also classify the baby as a female despite a male genotype.[1] Moreover, it is important to note that medicine and, more importantly, Islam define sex as either one of two: male or female. The Quran, when referring to the creation of humans, limits the creation to men and women,[2] in pairs,[3] and that individuals fall in one of four categories: those granted daughters; those granted sons; those granted both; and those granted neither.[4] The Sharia recognizes neither a third sex nor a combination of both sexes in one individual.[5]

The Sharia does, however, accept that certain substances can change into others such that an entirely new set of rules apply. When wine converts to vinegar, for example, it no longer carries the ruling of impurity and impermissibility, but rather becomes pure and sunnah. This type of change is only considered when the substance completely transmutes into an entirely new substance, as opposed to superficial changes, such as changing from solid to liquid and vice-versa.[6] One must analyze the degree of changes a transgender undergoes via Sex Reassignment Surgery and hormone therapy to understand whether the individual transmutes into another sex thereafter.

Sex Reassignment Surgery

Sex Reassignment Surgery (SRS), commonly referred as a sex change operation, is a set of medical procedures that aims to transform the physical aspects of one’s body in order to resemble the opposite gender. The numerous possible procedures one may opt-into include changes to both the upper and the lower body, including the genitalia. However, the body contouring, breast augmentation, facial masculinization/feminization surgery, and other upper body surgeries clearly do not transform a person into another sex; rather, it helps the person resemble the opposite sex. Similarly, surgeries on the genitalia do not actually implant or bring about the private parts of the opposite gender onto a person; instead, one’s own body parts are either inverted, grafted, or implanted to resemble the opposite sex. Evidenced by the fact that plastic surgeons perform these surgeries, a transgender merely instills superficial, physical changes onto oneself that produce no actual sexual transformation.

Hormone Therapy

Men and women both produce testosterone and estrogen, albeit in vastly different amounts. Hormone therapy for transmen involves increasing the testosterone levels within the body to induce male characteristics, such as facial and body hair, while it involves increasing the estrogen levels for transwomen to induce female characteristics, such as breast formation.[7] However, the hormone therapy brings about mostly physical changes, such as redistribution of body fat and the other examples mentioned above; the internal body does not fundamentally change. The genotype (presence or absence of the Y chromosome) cannot change and the body will never naturally produce the elevated levels of hormones induced through such treatment. The transgender individual will continue to be on a life-long treatment, forcing the body to act in a particular manner while the body fights back to return to its nature. The hormone therapy, similar to the SRS, does not transmute the body or otherwise truly convert the person into another sex. It only helps the person feel like another sex.

Furthermore, one may pursue hormone therapy with or without SRS, meaning that a transman may still retain ovaries and a uterus, which makes it possible for her to become pregnant and deliver a child. Hypothetically, if one assumes that hormone therapy transforms one’s sex, then in the cases of transmen who have carried pregnancies and delivered multiple children, it would mean that a man gave birth and the children have two fathers and no mother![8]

Differentiation from Intersexes

Based on the above facts and upon consulting with numerous Muslim endocrinologists, including those who administer hormone therapy to transgender individuals, it is evident that neither Sex Reassignment Surgery nor hormone therapy result in a genuine transformation from one sex to another, even if it results in some physical changes. These procedures fall under the prohibition of changing the creation of Allah (taghyīr khalqillāh), which the Quran explicitly identifies as a tool of Shayṭān.[9]The results of such procedures extend only to apparent resemblance of the opposite sex, not a conversion into it. The Prophet (peace and blessings be upon him) forbade distortion of the body,[10] including the genitals,[11] and cursed the one who imitates the opposite sex,[12] these procedures being an extreme example of it.

Although the scholars agree on the impermissibility of the surgery and that true transformation into a new sex is impossible, some have stated that the transgender individuals who have undergone these procedures will adopt the rulings of the sex they outwardly resemble. They derive their ruling from the guidance of the jurists on determining the sex of an intersex (khunthā), a person with ambiguous genitalia, based off the apparent physical attributes.[13] However, one can see the clear inconsistency between stating that a man who undergoes SRS and hormone therapy does not transform into a woman, yet adopts the rulings of a woman, and that a woman who undergoes such procedures remains a woman, yet adopts the rulings of a man. The flaw in the logic stems from comparing transgender individuals to intersexes, although the two are entirely different. The jurists’ guidance on analyzing intersexes based on their outward attributes aims to solve for the unknown sex of the child. The rulings of intersexes establish the birth sex; it does not apply on cases where one’s sex was already established. In fact, the jurists explicitly state that their guidance on intersexes applies prior to puberty, as any ambiguity around one’s sex ends at that point.[14] The discussion of intersexes relates to tabyīn al-jins (clarifying the sex), while the discussion of transgenders relates to tabdīl al-jins (changing the sex). Hence, any analogies on intersexes do not hold weight.

Conclusion

Since neither Sex Reassignment Surgery nor hormone therapy genuinely transform a person into another sex, nor is such possible, a transgender individual who undergoes either or both procedures remains the same sex and the rulings of that sex continue to apply.[15] Given that such a person outwardly resembles an opposite sex, some rules based off precaution shall apply, the details of which fall outside the scope of this resolution and for which one may consult his/her local Dār al-Iftāʾ.

Although one’s gender dysphoria, a psychological condition where one feels at odds with their biological sex,[16] may encourage one to undergo such procedures, one must remain aware of the grave sin in doing so. One does not have full rights over one’s body, but rather one must treat it in accordance with the laws of the Sharia.[17] At the same time, although one regards and treats such individuals as per their original sex, one must also maintain compassion for the individuals themselves, even if one disapproves of their actions, especially since psychological illness underlies such behavior. Any taunting, discrimination, or other harassment of transgender individuals is both illegal and not in the spirit of the Sharia.